Endoscopic devices have been commonly used for various procedures, typically in the abdominal area. Endoscopy is the examination and inspection of the interior of body organs, joints or cavities through an endoscope. Endoscopy allows physicians to peer through the body's passageways. An endoscopic procedure may be used to diagnose various conditions by close examination of internal organ and body structures and may also guide therapy and repair, such as the removal of torn cartilage from the bearing surfaces of a joint. A biopsy, a procedure involving tissue sampling for pathologic testing, may also be performed under endoscopic guidance. For example, endoscopic procedures include the following known procedures: gastroscopy, sigmoidoscopy and colonoscopy, esophago gastro duodenoscopy (EGD), endoscopic retrograde cholangiopancreatography (ERCP), and bronchoscopy.
The use of endoscopic treatments has recently increased for some diseases occurring in the gastrointestinal or pancreatobiliary duct systems. Endoscope systems are used frequently for diagnostic procedures, including contrast imaging of biliary or pancreatic ducts. Endoscopes are also used in procedures for retrieving gallstones that exist in the common bile duct and elsewhere.
Typically, these treatments are performed in the pancreatic duct, bile duct, and the hepatic duct by positioning the distal end of an endoscope in the vicinity of the duodenal papilla. Once the endoscope is in place, a wire guide is delivered to the target anatomy via the working channel of the endoscope. In order to guide the wire guide (or other medical instruments), out of the working channel of the endoscope, a rigid elevator is typically used to orient or deflect the distal end of the wire guide. When the distal end of the wire guide is properly oriented, the wire guide is inserted into the target anatomy.
At this point in the procedure, a catheter or similar treatment instrument can be passed over the wire guide either in a conventional over-the-wire style or in a rapid exchange style to the target anatomy. In order to limit movement of the wire guide relative to the target anatomy, the distal or proximal ends of the guide wire can be locked relative to the endoscope.
Many current endoscopic systems include endoscopes having an elevator used to orient and/or to lock the distal end of the catheter or wire guide. In many of such endoscopes, the elevator includes a v-shaped groove. The v-shaped groove is typically used to guide the catheter or wire guide to a central position relative to the endoscope. The elevator having a v-shaped groove is further used to lock the distal end of the catheter or guide wire.
Endoscopes using a rigid elevator lock and/or a v-shaped groove arrangement, however, may be improved. For example, in many situations, the elevator may tear, scrape, or otherwise affect wire guides or other instruments used therewith. This is particularly a problem with soft, Teflon™-coated wire guides. When such wire guides are positioned within the v-shaped groove of the elevator, even slight axial movement of the wire guide may result in a torn, scraped, or stripped wire guide. Such damage to a wire guide may undesirably require replacing the wire guide during the procedure. This, in turn, undesirably lengthens the overall procedure time and may increase the cost thereof.
Many other endoscopes are provided with rigid, flat-edged elevators. One challenge is that wire guide orientation is difficult to control with flat-edged elevators. Specifically, the wire guide tends to move from side to side relative to the elevator, thereby challenging the physician to insert the wire guide into a target anatomy. Moreover, when flat-edged elevators are used to lock the distal end of an instrument, tearing, scraping, stripping or other undesirable effects on the instrument can also result.
Another issue is that during use the elevator may compress elongate devices such as catheters, thereby preventing the passage of fluids therethrough or impeding the operation of the catheter device.
Thus, there is a need for an elevator design that relatively firmly grasps a elongate medical device and reduces the risk of tearing, scraping, or stripping of devices (e.g., wire guides or catheter) during deployment in a body vessel and allows flow of fluid therethrough during use.